[ RadSafe ] Hospital emergency response and RDD waste managem ent

Wed Mar 2 23:16:53 CET 2005

As a side note, how do biological contaminates alter this scenario?

-----Original Message-----
From: Sinclair, Michael [mailto:Sinclair at iema.state.il.us]
Sent: Wednesday, March 02, 2005 1:48 PM
To: 'radsafe at radlab.nl'
Subject: RE: [ RadSafe ] Hospital emergency response and RDD waste
managem ent

I agree that radiological decon fluids should go "down the drain",
especially when you're addressing a mass casualty situation, and that's the
advice I've given hospitals for years. But the bigger issue is what to do
with contaminated bulk items, such as clothing, shoes, dressings,
instruments (many of which are disposable these days), and so forth.  We
teach emergency medical personnel to double-bag the stuff and get it out of
the treatment area as quickly as possible so it is not a continuing source
of exposure. The question is where to put it.  It doesn't belong in the
normal waste stream, yet only the largest hospitals have the mechanisms for
holding rad waste temporarily and even then, the storage capacities are
relatively small.  Part of the pre-planning scheme has to take into account
when your capacity will be reached and you need to call for help.
It goes without saying that intentionally or unintentionally, a secondary
target of any terrorist-related WMD incident is the medical services
delivery system. The public chaos and fear created by a "dirty bomb" will
increase exponentially if it becomes necessary to close hospital emergency
rooms due to an exposure risk from contamination.

Mike Sinclair
REP Coordinator
IEMA
217-524-0888

-----Original Message-----
From: Vernig, Peter G. [mailto:Peter.Vernig at med.va.gov]
Sent: Wednesday, March 02, 2005 2:35 PM
To: 'Bradt, Clayton'; Radsafe (radsafe at radlab.nl)
Subject: RE: [ RadSafe ] Hospital emergency response and RDD waste
managem ent

Bradt and Group,

I had replied privately to the originator and will restate some of what I
said here.  I personally would not collect anything from a mass
contamination event.

First of all a little math.  A low flow shower head runs about 3.5 gallons
per minute, [apologies to our metric brethren that's 13.3 liters]  Being
optimistic say 5 minutes so 17. 5 gallons or 66.5 l per person.  That is 3
people to fill a standard 55 gallon [210 l, don't really know if Europe or
test of the world use something similar to our 55 gallon drum but it is a
very common standard shipping container for liquids.]  Anyway 30 people
would mean 10 and 100 people would mean 33 or 34.  How many of you have that
many readily available?

In other words where would you store collected personal decon run off?

And I think the sentiment in Bradt's response regarding planning would also
apply.  I wouldn't collect anything radioactive or chemical [agents] toxins
because it might be years before one could get rid of it.  I would run it
right into the sewer or storm drain, counting on massive dilution to render
it innocuous.  What else can you do really, when you think about it.  Most
hospitals are not going to have the liquid storage capacity.  One of the VA
hospitals put in about a 2000 gallon (7600 l) holding tank, that would be
good for about 114 patients/deconees.

Bear in mind also that if something were done at a sports stadium with say
50,000 in attendance affecting say 10% or 5000.  Local hospitals would
likely see 10 to 50,000 that were actually in attendance plus thousands that
were near of for some reason wanted to be sure.  With those kinds of numbers
we just would have no option but to drain it to sewer or storm drains.

Any opinions in this e-mail are solely those of the author, and are not
represented as those of the VA Eastern Colorado HCS, the Dept. of Veterans
Affairs, or the US Government.

Peter G. Vernig, Radiation Safety Officer, MS-115, VA Eastern Colorado
Health Care System, 1055 Clermont St. Denver, CO 80220,
peter.vernig at med.va.gov, Phone= 303.399.8020 x2447; Fax = 303.393.5026,
alternate fax, 303.393.5248

"...whatever is true, whatever is noble, whatever is lovely, whatever is
admirable, if anything is found to be excellent or praiseworthy, let your
mind dwell on these things."

Paul of Tarsus

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl]On
Behalf Of Bradt, Clayton
Sent: Wednesday, March 02, 2005 12:27 PM
To: Radsafe (radsafe at radlab.nl)
Subject: FW: [ RadSafe ] Hospital emergency response and RDD waste
managem ent

Any realistic solution to the problem of rad waste following an RDD event
would be so hateful to the eco-crazies that it would be impossible for any
government agency to ever make such a plan public before the fact.  I am
unaware of anyone actually working on such a plan.  I suspect that any
decisions on what to do about rad waste will be made ad hoc during the
crisis when there will be no time for opponents to get organized against
them.

Clayton J. Bradt, CHP
Principal Radiophysicist
NYS Dept. of Labor
phone: (518) 457 1202
fax:     (518) 485 7406
e-mail: clayton.bradt at labor.state.ny.us

-----Original Message-----
From: Andrew Lukban [mailto:ALukban at chpnet.org] 
Sent: Tuesday, March 01, 2005 5:20 PM
To: radsafe at radlab.nl
Subject: [ RadSafe ] Hospital emergency response and RDD waste management

I am the RSO in a hospital in New York City. Our hospital Emergency
Management Committee has been charged with planning a procedure of
response to emergency situations associated with radiation dispersal
devices (RDD's or "dirty bombs".) It is rumored that the next round of
city-wide table-top exercises for emergency preparedness are to involve
RDD scenarios. There are many things invloved with such a scenario which
range from detection (portal monitors), isotope identification (handheld
MCA), determination of internal decontamination (swab nostrils and mouth
and count), actual decontamination (undress, shower), calculation of
scheduled quantities in sewage from mass showering (close my eyes),
treatment (should be teh doc's job), dose calculations (call REAC/TS)
and... waste management (?).

I can almost deal with all the first steps but find myself bothered by
"waste management". I suppose it is not "waste" but, rather, "evidence"
if it were involved with an act of terrorism. What could be used for an
RDD? By nature of it being "dispersed" to cause maximum panic, it is
also more spread out and less concentrated when concerns about
contamination are brought up. This is different then from a single
source planted in one place and resulting in plain ol' external exposure
because the hospital would not be dealing with radiaiton contaminated
patients and produce radiation "waste" that I would ten have to deal
with.

Liquid RAM would likely be stolen from a medical purpose (likely imaging
and not oncology) and is likely the the easiest to disperse but is also
the shortest lived. Longer lived, higher specific activity material have
half-lives > 65 days and usually is from a solid form and would have to
be crushed for dispersal if the mode of dispersal is not via explosion.
It is interesting to note that regulations prevent us from doing
decay-in-storage for materials with half-lives >65 days. I would be
requird to return it to the "vendor" - "Hello Mr Terrorist, here's your
stuff back." No matter. Either way, both short lived and long lived RAM
"waste" now present at the hospital resulting from decon, emesis, feces,
etc. would not have been "purchased according to our license" and the
institution should not be responsible for storing or disposing it. We
can follow due diligence in preparing for proper radiation safety
procedure to contain and isolate the stuff, but what is the limit of
preparation? Should we prepare for storing clothing contaminated with
therapeutic amounts of powdered Co-60? How many Pb lined steel drums is
considered OK? What government entity will say that the "foreign RAM of
extramural origin" is "their problem" and will pick it up? Should I be
pursuing a memo of understanding with some magically appropriate
government entity? Real estate is big problem in NYC and there is no
"spare parking lot" that can be used to contain RAM in an emergency
scenario.

The more I think about it, the more I think that the conclusion is that
"radioactive waste" from an RDD emergency is NOT the hospital's problem
in the long term. However, what is considered the short term (when will
it no longer be my problem because someone will remove it) and who is
going to be responsible for it (who will remove it)?

Sorry for the venting...

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